G9468 — Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
G9468 is a HCPCS Level II code for patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G9468
- Long descriptor
- Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
- Short descriptor
- No recd cortico>=10mg/d >60d
- Added
- January 1, 2015
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G9468
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9468 is not quite right, the correct code is very often within a few positions of it.
- G9458Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco userterminated
- G9459Currently a tobacco non-userterminated
- G9460Tobacco assessment or tobacco cessation intervention not performed, reason not giventerminated
- G9463I intend to report the sinusitis measures groupterminated
- G9464All quality actions for the applicable measures in the sinusitis measures group have been performed for this patientterminated
- G9465I intend to report the acute otitis externa (aoe) measures groupterminated
- G9466All quality actions for the applicable measures in the aoe measures group have been performed for this patientterminated
- G9467Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve monthsterminated
- G9469Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fillsterminated
- G9470Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills
- G9471Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented
- G9472Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribedterminated
- G9473Services performed by chaplain in the hospice setting, each 15 minutes
- G9474Services performed by dietary counselor in the hospice setting, each 15 minutes
- G9475Services performed by other counselor in the hospice setting, each 15 minutes
- G9476Services performed by volunteer in the hospice setting, each 15 minutes
Questions about G9468
What is HCPCS code G9468?
G9468 is a HCPCS Level II code for patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9468?
The CMS HCPCS file marks G9468 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G9468 paid under the physician fee schedule?
G9468 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.